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FORM C42Tennessee Bureau of Workers Compensation 220 French Landing Drive, IB Nashville, Tennessee 372431002 EMPLOYEES CHOICE OF PHYSICIANAn employer must provide a partiallycompleted form listing
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What is indicates form physician chosen?
The indicates form physician chosen is a document that allows patients to designate a specific physician or healthcare provider to manage their medical care.
Who is required to file indicates form physician chosen?
Typically, patients are required to file the indicates form physician chosen when they want to formally select a physician as their primary healthcare provider.
How to fill out indicates form physician chosen?
To fill out the indicates form physician chosen, patients should provide their personal information, the name of the chosen physician, and any additional required details as specified on the form.
What is the purpose of indicates form physician chosen?
The purpose of the indicates form physician chosen is to ensure that a patient's healthcare decisions are respected and that their chosen physician is notified of their preference for care.
What information must be reported on indicates form physician chosen?
Information that must be reported includes the patient's name, contact information, insurance details, the name and contact information of the chosen physician, and signatures as required.
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